| NPI | 1124751961 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WV 106787) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MD AC004537) |
| Enumeration Date | 2022-07-08 |
| Last Update Date | 2024-09-05 |