| NPI | 1275776692 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner Primary Care (Licence: OH 11094) |
| Additional Taxonomies | 163WP2201X Registered Nurse Ambulatory Care (Licence: WV 31101) |
| 363LF0000X Nurse Practitioner Family (Licence: WV 31101) | |
| Enumeration Date | 2009-04-15 |
| Last Update Date | 2022-12-15 |