| NPI | 1063807006 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: OH APRN.CNP.022149) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: OH APRN.CNP.17066) |
| 363LF0000X Nurse Practitioner Family (Licence: WV APRN87239-NP-C) | |
| Enumeration Date | 2015-04-06 |
| Last Update Date | 2022-06-14 |