| NPI | 1912111972 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: FL 9314661) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OH COA09382) |
| Enumeration Date | 2007-05-09 |
| Last Update Date | 2020-09-11 |