| NPI | 1053850867 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: OH 024035) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: WV 81237) |
| Enumeration Date | 2017-02-14 |
| Last Update Date | 2021-05-18 |