| NPI | 1649562901 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MD R174165) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WV APRN68157-NP-C) |
| Enumeration Date | 2011-05-05 |
| Last Update Date | 2021-05-21 |