| NPI | 1982793717 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 242558) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 4986P) |
| 363L00000X Nurse Practitioner (Licence: OH NP-09064) | |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2016-12-08 |