| NPI | 1366094823 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WV 103822) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: PA SP021913) |
| 363LF0000X Nurse Practitioner, Family (Licence: MD AC002833) | |
| Enumeration Date | 2019-07-15 |
| Last Update Date | 2022-04-15 |