| NPI | 1538712138 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LC0200X Nurse Practitioner, Critical Care Medicine (Licence: WV 104046) |
| Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: WV 104046) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: WV 104046) | |
| Enumeration Date | 2019-07-23 |
| Last Update Date | 2019-08-21 |