| NPI | 1467648717 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WV 46606) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OH APRN.CNP.09810) | 
| 363LF0000X Nurse Practitioner, Family (Licence: OH 308217) | |
| Enumeration Date | 2007-09-20 | 
| Last Update Date | 2020-06-01 |