| NPI | 1124412879 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OH COA 17155) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WV 123657) |
| Enumeration Date | 2015-03-20 |
| Last Update Date | 2026-02-20 |