| NPI | 1417471582 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OH APRN.CNP.021458) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OH pending) |
| 363LF0000X Nurse Practitioner, Family (Licence: WV 105083) | |
| Enumeration Date | 2017-08-01 |
| Last Update Date | 2022-10-13 |