| NPI | 1407560402 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: WV 91990) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: WV 123472) |
| Enumeration Date | 2023-01-13 |
| Last Update Date | 2026-03-04 |