| NPI | 1619578283 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: WV APRN-CNP107599) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: OH APRN.CNP.026461) |
| Enumeration Date | 2020-11-02 |
| Last Update Date | 2022-04-18 |