| NPI | 1568720381 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NC 5010517) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WV 62109) |
| Enumeration Date | 2012-04-30 |
| Last Update Date | 2018-05-23 |