| NPI | 1275147324 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WV 106784) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MD ACOO3351) |
| Enumeration Date | 2020-09-05 |
| Last Update Date | 2021-12-30 |