| NPI | 1932567963 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: OH COA.18345-NP) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: OH COA.18345-NP) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: OH COA.18345-NP) | |
| Enumeration Date | 2016-02-04 |
| Last Update Date | 2021-01-13 |