| NPI | 1124095740 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OH APRN.CNP.072976) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WV 48274) |
| Enumeration Date | 2006-03-02 |
| Last Update Date | 2024-09-13 |