| NPI | 1740590140 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OH APRN.CNP.12059) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WV 44336) |
| Enumeration Date | 2010-10-19 |
| Last Update Date | 2020-05-06 |