| NPI | 1366026965 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: WV 109028) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WV 109028) |
| 163W00000X Registered Nurse (Licence: OH 407847) | |
| 363LF0000X Nurse Practitioner Family (Licence: OH 0028668) | |
| Enumeration Date | 2021-05-10 |
| Last Update Date | 2022-04-04 |