| NPI | 1770160194 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OH APRN.CNP.0027186) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WV 106796) |
| 363L00000X Nurse Practitioner (Licence: KY 3014378) | |
| Enumeration Date | 2021-03-24 |
| Last Update Date | 2023-12-04 |