| NPI | 1255665485 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WV 71371) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 6152P) |
| Enumeration Date | 2009-09-21 |
| Last Update Date | 2014-11-07 |