| NPI | 1720522741 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WV 110814) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OH 021143) |
| Enumeration Date | 2016-12-09 |
| Last Update Date | 2021-12-13 |