| NPI | 1043628654 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024171811) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WV APRN64461NP) |
| Enumeration Date | 2014-07-27 |
| Last Update Date | 2018-09-24 |