| NPI | 1619226115 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WV 64568) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OH COA 13682) |
| Enumeration Date | 2012-08-30 |
| Last Update Date | 2021-12-02 |