| NPI | 1619085719 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OH 12882-NP) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WV 33491) |
| Enumeration Date | 2006-08-28 |
| Last Update Date | 2020-05-13 |