| NPI | 1164834651 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WV APRN70774) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OH COA.15773-NP) |
| 363L00000X Nurse Practitioner (Licence: WV 70774) | |
| Enumeration Date | 2014-06-02 |
| Last Update Date | 2022-03-31 |