| NPI | 1588645378 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WV 115829) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024165328) |
| Enumeration Date | 2005-11-08 |
| Last Update Date | 2024-06-08 |