| NPI | 1013015577 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: WV 38289) |
| Additional Taxonomies | 163WR0006X Registered Nurse Registered Nurse First Assistant (Licence: WV 38289) |
| 363L00000X Nurse Practitioner (Licence: PA SP007721) | |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2019-02-23 |