| NPI | 1952525875 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 152745) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OH COA 05213 NP) |
| Enumeration Date | 2007-04-12 |
| Last Update Date | 2013-03-21 |