| NPI | 1205137270 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: WV APRN86017-NP-C) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: OH COA 11727) |
| Enumeration Date | 2010-11-08 |
| Last Update Date | 2014-02-28 |