| 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 |