| NPI | 1255163598 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WV 120430) |
| Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: WV 120430) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: WV 120430) | |
| Enumeration Date | 2024-08-15 |
| Last Update Date | 2024-08-15 |