| NPI | 1538260880 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WV 60299) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OH 06964) |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2015-05-26 |