| NPI | 1689332645 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WV 109790) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024183181) |
| Enumeration Date | 2021-12-07 |
| Last Update Date | 2023-08-23 |