| NPI | 1780865048 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WV 28420) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OH COA.04134-NP) |
| 363LF0000X Nurse Practitioner, Family (Licence: WV 0239324-22) | |
| Enumeration Date | 2007-11-15 |
| Last Update Date | 2022-11-04 |