| NPI | 1205583036 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WV 112058) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WV 73241) |
| Enumeration Date | 2022-03-02 |
| Last Update Date | 2023-08-09 |