NPI | 1285029454 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WV APPRN71036) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OH COA 17024-NP) |
Enumeration Date | 2015-04-03 |
Last Update Date | 2015-04-03 |