| NPI | 1912298209 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ 218787) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH 368204) |
| 363LF0000X Nurse Practitioner, Family (Licence: OH CNP023619) | |
| Enumeration Date | 2011-04-21 |
| Last Update Date | 2022-08-01 |