| NPI | 1255375192 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5018691) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WV 57927) |
| 363LA2100X Nurse Practitioner, Acute Care (Licence: OH NP-05417) | |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2023-09-15 |