| NPI | 1780980102 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OH 12060) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WV 68395) |
| Enumeration Date | 2011-02-02 |
| Last Update Date | 2024-04-01 |