| NPI | 1003455403 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: WV 117113) |
| Additional Taxonomies | 163WL0100X Registered Nurse Lactation Consultant (Licence: WV L-160867) |
| Enumeration Date | 2020-01-02 |
| Last Update Date | 2023-08-01 |