| NPI | 1730263351 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: WV APRN77971) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: PA SP009180) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: OH APRN.CNP.11534) | |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2023-05-05 |