| NPI | 1558322669 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: OH COA.14136-NP) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: WV 33982) |
| Enumeration Date | 2006-03-29 |
| Last Update Date | 2013-04-29 |