| NPI | 1942734116 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NM 57168) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OH 020604) | 
| Enumeration Date | 2017-04-14 | 
| Last Update Date | 2025-01-04 |