| NPI | 1295989119 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WV 63250) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WV 63250) |
| Enumeration Date | 2008-11-05 |
| Last Update Date | 2010-12-06 |