| NPI | 1447861422 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WV 107083) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WV 96341) |
| 163W00000X Registered Nurse (Licence: MI 4704221100) | |
| 163WD0400X Registered Nurse, Diabetes Educator (Licence: WV 21600468) | |
| Enumeration Date | 2020-08-12 |
| Last Update Date | 2020-08-12 |