| NPI | 1578192290 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OH 026329) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WV 105510) |
| Enumeration Date | 2020-04-04 |
| Last Update Date | 2024-03-27 |