| NPI | 1518900570 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WV 56357) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WV 56357) |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2012-04-20 |