| NPI | 1023445087 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5019212) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WV 44489) |
| Enumeration Date | 2013-10-03 |
| Last Update Date | 2024-01-02 |