| NPI | 1811178221 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WV 71585) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH 337444) |
| 363LF0000X Nurse Practitioner, Family (Licence: KY 3008665) | |
| Enumeration Date | 2007-11-14 |
| Last Update Date | 2021-03-26 |