| NPI | 1083951628 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OH RN173692-COA1) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WV 70229) |
| Enumeration Date | 2013-01-15 |
| Last Update Date | 2013-01-15 |