NPI | 1396080313 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WV 26919) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OH 14241) |
Enumeration Date | 2012-12-02 |
Last Update Date | 2024-07-04 |