| NPI | 1508119199 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OH 13985) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WV 73879) |
| Enumeration Date | 2012-10-19 |
| Last Update Date | 2012-10-19 |