| NPI | 1073030573 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 9330900) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WV APRN78014-FNP-BC) |
| Enumeration Date | 2017-08-25 |
| Last Update Date | 2020-06-24 |