| NPI | 1356003370 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WV 120810) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001267325) |
| Enumeration Date | 2021-10-07 |
| Last Update Date | 2024-11-21 |