| NPI | 1558760264 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: WV 60163) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WV 60169) |
| Enumeration Date | 2014-08-19 |
| Last Update Date | 2022-09-12 |