| NPI | 1912648890 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: VA 0024186543) |
| Additional Taxonomies | 163WP0200X Registered Nurse, Pediatrics (Licence: OH RN.485488) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: OH APRN.CNP.0032099) | |
| Enumeration Date | 2022-04-05 |
| Last Update Date | 2023-03-25 |