| NPI | 1407319726 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WV 102686) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024179101) |
| Enumeration Date | 2019-04-12 |
| Last Update Date | 2025-06-12 |