| NPI | 1912954561 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OH COA.13367-NP) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: LA AP03741) |
| Enumeration Date | 2006-05-28 |
| Last Update Date | 2012-10-22 |