| NPI | 1134853278 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WV 113814) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WV 98162) |
| Enumeration Date | 2022-07-14 |
| Last Update Date | 2022-08-24 |