| NPI | 1366903411 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WV 58934) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH RN.446469) |
| Enumeration Date | 2019-03-29 |
| Last Update Date | 2021-10-25 |