| NPI | 1508403106 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: WV 75954) |
| Additional Taxonomies | 163WD0400X Registered Nurse, Diabetes Educator (Licence: WV 75954) |
| Enumeration Date | 2019-12-03 |
| Last Update Date | 2019-12-03 |