| NPI | 1346301785 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WV 57766) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MD R157962) |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2021-03-11 |