| NPI | 1912313719 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WV APRN71004-NP-C) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OH COA.15798-NP) |
| Enumeration Date | 2014-07-01 |
| Last Update Date | 2016-01-26 |