| NPI | 1568036226 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WV 110302) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024178493) |
| Enumeration Date | 2021-05-18 |
| Last Update Date | 2021-10-15 |