| NPI | 1083604441 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WV 34033) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WV 34033) |
| Enumeration Date | 2005-10-26 |
| Last Update Date | 2025-09-26 |