| NPI | 1639807969 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WV 114578) |
| Additional Taxonomies | 163WM0705X Registered Nurse, Medical-Surgical (Licence: WV 89228) |
| Enumeration Date | 2022-08-14 |
| Last Update Date | 2022-10-03 |