| NPI | 1689206716 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WV 105400) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024178665) |
| Enumeration Date | 2020-02-06 |
| Last Update Date | 2021-06-30 |