| NPI | 1518279546 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WV 57295) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 49197) |
| Enumeration Date | 2010-07-07 |
| Last Update Date | 2021-11-18 |