| NPI | 1568764835 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: PA SP011001) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WV 57996) |
| 363LF0000X Nurse Practitioner, Family (Licence: OH COA1171NP) | |
| Enumeration Date | 2010-11-18 |
| Last Update Date | 2020-05-13 |