| NPI | 1912123902 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OH COA.17993-NP) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: OH 5418) |
| Enumeration Date | 2007-04-18 |
| Last Update Date | 2016-11-10 |