| NPI | 1497102818 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5011263) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WV 72510) |
| 163W00000X Registered Nurse (Licence: OH RN.408791-1) | |
| 163W00000X Registered Nurse (Licence: NC 309908) | |
| Enumeration Date | 2016-05-16 |
| Last Update Date | 2019-03-01 |