| NPI | 1265439384 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OH COA.05133-NP) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WV 37484) |
| Enumeration Date | 2005-07-05 |
| Last Update Date | 2018-01-29 |