| NPI | 1194002162 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OH NP13208) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WV 68316) |
| Enumeration Date | 2011-11-04 |
| Last Update Date | 2018-01-29 |