| NPI | 1154144194 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WV 109439) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: WV 109439) |
| Enumeration Date | 2024-11-07 |
| Last Update Date | 2025-05-29 |