| NPI | 1912604539 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: NM 79627) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OH 0032705) |
| Enumeration Date | 2023-02-14 |
| Last Update Date | 2024-11-18 |