| NPI | 1902233844 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 18447) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OH COA.15218-NP) |
| Enumeration Date | 2013-10-10 |
| Last Update Date | 2019-07-10 |