| NPI | 1194722272 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: OH APRN.CNP.03535) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: WV 30941) |
| Enumeration Date | 2005-07-05 |
| Last Update Date | 2017-02-03 |