| NPI | 1518605765 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WV 113661) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WV 99130) |
| 363L00000X Nurse Practitioner (Licence: WV 113661) | |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: WV 113661) | |
| Enumeration Date | 2022-05-26 |
| Last Update Date | 2024-07-16 |