| NPI | 1356020051 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WV 117268) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WV 93394) |
| 363L00000X Nurse Practitioner (Licence: WV 117268) | |
| Enumeration Date | 2023-07-12 |
| Last Update Date | 2025-10-03 |