| NPI | 1518443050 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WV 104210) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: PA SP018991) |
| Enumeration Date | 2018-07-18 |
| Last Update Date | 2022-09-15 |