| NPI | 1619682408 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WV 115445) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MD AC007361) |
| Enumeration Date | 2023-01-17 |
| Last Update Date | 2025-04-09 |