| NPI | 1811933146 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WV 55993) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WV WV55993) |
| Enumeration Date | 2006-06-22 |
| Last Update Date | 2020-04-01 |