| NPI | 1730514506 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: FL 9346594) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: KY 3008272) |
| 363LF0000X Nurse Practitioner Family (Licence: WV 87104) | |
| Enumeration Date | 2013-09-11 |
| Last Update Date | 2020-06-25 |