| NPI | 1912442179 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: OH CNP-020426) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: OH AG1116006) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: OH AG111006) | |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: OH AG1116006) | |
| Enumeration Date | 2016-12-27 |
| Last Update Date | 2020-12-21 |