| NPI | 1588069561 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: WV APPLIED FOR) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: OH APPLIED FOR) |
| 363LF0000X Nurse Practitioner Family (Licence: PA APPLIED FOR) | |
| Enumeration Date | 2014-11-03 |
| Last Update Date | 2014-11-03 |