| NPI | 1861858003 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OH COA18527 NP) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WV 42888) |
| Enumeration Date | 2016-01-04 |
| Last Update Date | 2020-05-21 |