| NPI | 1720343130 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WV 75957) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: PA SP012420) |
| Enumeration Date | 2012-07-11 |
| Last Update Date | 2023-06-29 |