| NPI | 1679345052 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: WV 107095) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: PA SP028314) |
| Enumeration Date | 2023-10-27 |
| Last Update Date | 2023-10-27 |