| NPI | 1760968762 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WV APRN101395-NP-C) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OH APRN.CNP.023156) |
| Enumeration Date | 2018-07-13 |
| Last Update Date | 2021-01-12 |