| NPI | 1891171401 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WV APRN72764) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WV 72764) |
| Enumeration Date | 2015-08-05 |
| Last Update Date | 2015-08-05 |