| NPI | 1912491630 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3012175) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OH APRN.CNP.022270) |
| Enumeration Date | 2018-06-16 |
| Last Update Date | 2018-06-16 |