| NPI | 1962080440 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3015445) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OH 0034173) |
| Enumeration Date | 2021-03-29 |
| Last Update Date | 2024-02-07 |