| NPI | 1962040394 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: OH APRN.CNP.025762) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH 374079) |
| 363LF0000X Nurse Practitioner Family (Licence: KY 3016094) | |
| Enumeration Date | 2019-12-16 |
| Last Update Date | 2022-02-25 |