| NPI | 1083250963 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WV 105016) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: WV 105016) |
| Enumeration Date | 2019-11-26 |
| Last Update Date | 2025-05-20 |