| NPI | 1528842648 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WV 117361) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WV 117361) |
| Enumeration Date | 2023-08-21 |
| Last Update Date | 2024-08-13 |