| NPI | 1750653291 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: WV APRN86910-PPCNP-BC) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: OH 2011009651) |
| Enumeration Date | 2012-01-30 |
| Last Update Date | 2015-09-04 |