| NPI | 1144575051 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WV 73152) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OH COA. 13511-NP) |
| Enumeration Date | 2012-07-17 |
| Last Update Date | 2012-07-17 |