| NPI | 1265839864 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WV APRN78249-NP-C) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OH COA.16844-NP) |
| Enumeration Date | 2014-11-25 |
| Last Update Date | 2014-11-25 |