| NPI | 1952740789 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NM CNP-03098) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OH COA-14504-NP) |
| Enumeration Date | 2013-06-14 |
| Last Update Date | 2021-02-24 |