| NPI | 1255668745 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: OH NP-10722) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: WV 22844) |
| Enumeration Date | 2009-11-04 |
| Last Update Date | 2009-11-04 |