| NPI | 1306208913 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: WV 104808) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: PA SP014941) |
| Enumeration Date | 2016-03-23 |
| Last Update Date | 2021-07-13 |