| NPI | 1316314412 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: SC 25357) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WV 71024) |
| 363LF0000X Nurse Practitioner Family (Licence: WV APRN71024-FNPBC) | |
| Enumeration Date | 2015-08-25 |
| Last Update Date | 2022-12-08 |