| NPI | 1215663083 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WV 113900) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WV 88751) |
| Enumeration Date | 2022-07-25 |
| Last Update Date | 2023-06-22 |