| NPI | 1154071264 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WV 113014) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OH 0031356) |
| 405300000X Prevention Professional (Licence: OH 0000837) | |
| Enumeration Date | 2022-03-24 |
| Last Update Date | 2023-02-03 |