| NPI | 1043877046 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WV 68364) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WV 102519) |
| Enumeration Date | 2019-05-24 |
| Last Update Date | 2024-05-30 |