| NPI | 1972103505 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OH APRN.CNP.0030537) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH RN.391922) |
| Enumeration Date | 2020-11-01 |
| Last Update Date | 2022-03-16 |