| NPI | 1083414957 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WV 106408) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WV 106408) |
| Enumeration Date | 2025-03-18 |
| Last Update Date | 2025-09-03 |