| NPI | 1962780924 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OH COA-12504-NP) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OH APRN.CNP.12504) |
| Enumeration Date | 2011-07-25 |
| Last Update Date | 2019-02-21 |