| NPI | 1265191456 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 30438) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WV 110787) |
| 363LF0000X Nurse Practitioner, Family (Licence: OH APRN.CNP.0031299) | |
| Enumeration Date | 2021-12-15 |
| Last Update Date | 2023-03-17 |