| NPI | 1245861129 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OH APRN.CNP.025883) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WV APRN.CNP.104883) |
| Enumeration Date | 2020-01-30 |
| Last Update Date | 2020-01-30 |