| NPI | 1912005620 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OH NP06844) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OH 06844NP) |
| 363LF0000X Nurse Practitioner, Family (Licence: WV 98044) | |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2021-11-29 |