| NPI | 1417365677 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: PA SP013948) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WV APRN78684-NP-C) |
| Enumeration Date | 2014-07-31 |
| Last Update Date | 2019-10-02 |