NPI | 1184723074 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WV 25623) |
Additional Taxonomies | 163WD0400X Registered Nurse, Diabetes Educator (Licence: WV 25623) |
Enumeration Date | 2006-09-21 |
Last Update Date | 2012-10-02 |