NPI | 1124574504 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WV 62667) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OH APRN.CNP.024436) |
Enumeration Date | 2016-08-26 |
Last Update Date | 2019-04-04 |