| NPI | 1750531349 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: WV APRN62515) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: WV 62515) |
| Enumeration Date | 2008-09-19 |
| Last Update Date | 2021-02-05 |