| NPI | 1639326747 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WV 95219) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 752404) |
| Enumeration Date | 2008-08-20 |
| Last Update Date | 2016-12-13 |