| NPI | 1336425081 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WV 97641) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: PA SP011681) |
| Enumeration Date | 2011-10-26 |
| Last Update Date | 2018-05-21 |