| NPI | 1760664296 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5005475) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WV 43226) |
| Enumeration Date | 2007-11-27 |
| Last Update Date | 2012-11-26 |