| NPI | 1356378152 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WV RN75515) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OH RN288177) |
| Enumeration Date | 2006-06-27 |
| Last Update Date | 2009-07-28 |