| NPI | 1558814111 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: WV APRN70960-FNP-BC) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WV 70960) |
| Enumeration Date | 2016-08-01 |
| Last Update Date | 2019-02-27 |