| NPI | 1164442356 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WV 26771) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WV F1105238) |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2015-12-16 |