| NPI | 1962767897 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OH coa 13465 np) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OH COA.13465-NP) |
| Enumeration Date | 2012-07-06 |
| Last Update Date | 2013-09-10 |