| NPI | 1912250101 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OH COA.13755-NP) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH RN.369035-COA1) |
| Enumeration Date | 2012-10-25 |
| Last Update Date | 2012-10-25 |