| NPI | 1114087780 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WV APRN83001-FNP-BC) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 4996P) |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2013-11-25 |