| NPI | 1013171172 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WV 77652) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: DC 44520) |
| Enumeration Date | 2008-07-17 |
| Last Update Date | 2012-07-13 |