| NPI | 1235673781 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WV 2016010343) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: PA SP018993) |
| Enumeration Date | 2016-12-16 |
| Last Update Date | 2018-08-28 |