| NPI | 1710675947 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: WV 118853) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH RN.506659) |
| Enumeration Date | 2023-04-26 |
| Last Update Date | 2024-05-09 |