| NPI | 1467108480 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WV 112284) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WV 94240) |
| Enumeration Date | 2022-02-28 |
| Last Update Date | 2022-03-15 |