| NPI | 1750790754 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IN 71008322A) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WV 2014014914) |
| 363LF0000X Nurse Practitioner, Family (Licence: OH COA.16884-NP) | |
| Enumeration Date | 2014-08-05 |
| Last Update Date | 2021-06-18 |