| NPI | 1902809452 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WV 44795) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WV 2005000034-22) |
| Enumeration Date | 2005-05-28 |
| Last Update Date | 2013-07-18 |