| NPI | 1801184833 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OH APRN.CNP.13517) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WV 67589) |
| 363L00000X Nurse Practitioner (Licence: PA SP011582) | |
| Enumeration Date | 2011-07-12 |
| Last Update Date | 2016-11-02 |