| NPI | 1164823753 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WV APRN71222FNPBC) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WV 71222) |
| Enumeration Date | 2014-09-15 |
| Last Update Date | 2022-04-08 |