| NPI | 1669802062 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WV APRN86295-FNP-BC) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WV APRN86295-FNP-BC) |
| Enumeration Date | 2013-11-21 |
| Last Update Date | 2020-04-03 |