| NPI | 1831529247 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: WV APRN59871-NP-C) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: VA 0024171128) |
| Enumeration Date | 2013-11-21 |
| Last Update Date | 2017-03-13 |