| NPI | 1891080008 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OH COA.12318-NP) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 801498) |
| Enumeration Date | 2011-06-15 |
| Last Update Date | 2016-03-13 |