| NPI | 1154307445 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5016535) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WV 35618) |
| Enumeration Date | 2005-12-19 |
| Last Update Date | 2023-03-23 |