| NPI | 1972853679 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: OH 03937) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: OH 119841) |
| Enumeration Date | 2012-09-11 |
| Last Update Date | 2020-06-28 |