NPI | 1073092607 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OH APRN.CNP.023685) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WV APRN73839NP) |
Enumeration Date | 2018-08-14 |
Last Update Date | 2023-08-31 |