| NPI | 1164183182 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WV 111496) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: OH 0030512) |
| Enumeration Date | 2022-01-02 |
| Last Update Date | 2026-02-18 |