| NPI | 1760681910 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WV 62175) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024166327) |
| Enumeration Date | 2007-07-17 |
| Last Update Date | 2007-07-17 |