| NPI | 1184164089 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024174662)  | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WV APRN73140-NP-C)  | 
| Enumeration Date | 2017-02-27 | 
| Last Update Date | 2024-02-05 |