| NPI | 1992319594 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: OH APRN.CNP.0027331) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: WV 107097) |
| 363LF0000X Nurse Practitioner Family (Licence: PA SP022301) | |
| Enumeration Date | 2020-09-02 |
| Last Update Date | 2021-03-17 |