| NPI | 1679066617 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OH APRN.CNP.024391) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WV APRN78641-NP-C) |
| Enumeration Date | 2018-06-13 |
| Last Update Date | 2020-08-18 |