| NPI | 1508565235 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WV 115636) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WV 89155) |
| Enumeration Date | 2023-03-02 |
| Last Update Date | 2023-06-28 |