| NPI | 1104344282 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner Primary Care (Licence: AL 1177516) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: WV APRN73533-FNP-BC) |
| Enumeration Date | 2017-09-08 |
| Last Update Date | 2021-05-18 |