| NPI | 1538632369 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WV 111511) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: VA 0024190173) |
| Enumeration Date | 2019-01-03 |
| Last Update Date | 2024-10-29 |