| NPI | 1639574361 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WV APRN69807) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WV 69807) |
| Enumeration Date | 2014-10-23 |
| Last Update Date | 2014-10-23 |