| NPI | 1285748103 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: WV 29063) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: OH 322430) |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2007-07-08 |