| NPI | 1003602871 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WV 120598) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WV 120598) |
| Enumeration Date | 2025-04-17 |
| Last Update Date | 2025-08-15 |