| NPI | 1356981252 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: WV 105091) |
| Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: WV 99857) |
| Enumeration Date | 2020-01-09 |
| Last Update Date | 2020-01-09 |