| NPI | 1639702616 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MD R224966) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024178313) |
| 363LF0000X Nurse Practitioner, Family (Licence: WV APRN87201) | |
| Enumeration Date | 2020-02-18 |
| Last Update Date | 2021-07-14 |