| NPI | 1134724826 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WV 107920) |
| Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: WV 58649) |
| Enumeration Date | 2020-12-01 |
| Last Update Date | 2020-12-08 |