| NPI | 1316685704 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OH APRN.CNP.0030681) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: LA 245657) |
| 363L00000X Nurse Practitioner (Licence: PA SP035283) | |
| 363L00000X Nurse Practitioner (Licence: KY 4052556) | |
| 363L00000X Nurse Practitioner (Licence: VA 0024196452) | |
| Enumeration Date | 2022-05-25 |
| Last Update Date | 2026-03-31 |