| NPI | 1720525512 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OH 19246) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WV 88398) |
| Enumeration Date | 2017-01-31 |
| Last Update Date | 2024-02-08 |