| NPI | 1205517646 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WV 110940) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: PA SP027853) |
| Enumeration Date | 2023-07-28 |
| Last Update Date | 2025-07-28 |