| NPI | 1255661955 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CO 0000841) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WV 40413) |
| Enumeration Date | 2010-01-04 |
| Last Update Date | 2023-03-30 |