| NPI | 1417031378 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WV 57566) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NC 201725) |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2007-12-20 |