| NPI | 1275887531 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 1108172) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WV APRN75923-FNP-BC) | 
| 363LF0000X Nurse Practitioner, Family (Licence: MD AC005770) | |
| Enumeration Date | 2012-11-07 | 
| Last Update Date | 2024-03-05 |