| NPI | 1609515972 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WV 79517) |
| Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: WV 79517) |
| Enumeration Date | 2022-06-03 |
| Last Update Date | 2024-04-11 |