| NPI | 1508647785 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: WV RN.119058) |
| Additional Taxonomies | 172V00000X Community Health Worker |
| Enumeration Date | 2023-10-12 |
| Last Update Date | 2026-01-27 |