| NPI | 1063583888 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WV 44422) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OH 07539) |
| 363L00000X Nurse Practitioner (Licence: PA SP010093) | |
| Enumeration Date | 2006-11-13 |
| Last Update Date | 2025-05-08 |