| NPI | 1598594491 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WV 120572) |
| Additional Taxonomies | 163WG0000X Registered Nurse General Practice (Licence: MA RN2374918) |
| Enumeration Date | 2024-07-29 |
| Last Update Date | 2024-09-22 |