| NPI | 1962048694 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3014243) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OH APRN.CNP.025539) |
| Enumeration Date | 2019-11-18 |
| Last Update Date | 2022-06-09 |