| NPI | 1639654007 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MD R223900) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WV 85447) |
| 163W00000X Registered Nurse (Licence: MD R223900) | |
| 363LF0000X Nurse Practitioner, Family (Licence: WV 107021) | |
| Enumeration Date | 2018-10-01 |
| Last Update Date | 2023-03-24 |