| 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 |