| NPI | 1356751820 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WV 103953) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: WV 1793) |
| Enumeration Date | 2014-05-05 |
| Last Update Date | 2024-08-27 |