| NPI | 1982702213 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OH COA 11271 NP) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024-167065) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2012-04-04 |