| NPI | 1932461472 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: OH 13379) | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OH COA.13379-NP) | 
| Enumeration Date | 2012-06-11 | 
| Last Update Date | 2020-10-26 |