| NPI | 1346634201 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WV 105864) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 9348293) |
| Enumeration Date | 2015-03-27 |
| Last Update Date | 2022-04-05 |