| NPI | 1427678259 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: WV 110411) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 11006894) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: GA 294046) | |
| Enumeration Date | 2020-04-22 |
| Last Update Date | 2021-09-01 |