| NPI | 1952579963 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WV 104911) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 12763) |
| Enumeration Date | 2008-02-12 |
| Last Update Date | 2024-04-26 |