NPI | 1588175392 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WV 123735) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OH APRN.CNP.021822) |
Enumeration Date | 2017-10-19 |
Last Update Date | 2025-08-28 |