| NPI | 1275063604 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: WV APRN68971) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WV APRN68971-NP-C) |
| Enumeration Date | 2017-06-18 |
| Last Update Date | 2025-08-27 |