| NPI | 1952306318 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OH COA07581NP)  | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OH 07581NP)  | 
| Enumeration Date | 2005-06-14 | 
| Last Update Date | 2010-03-02 |