| NPI | 1578539011 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: OH APRN.CNP.08645) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OH 321505) |
| 363LF0000X Nurse Practitioner, Family (Licence: WV 49179) | |
| Enumeration Date | 2006-02-24 |
| Last Update Date | 2022-03-08 |