| NPI | 1710577531 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WV 109622) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024179691) |
| Enumeration Date | 2021-01-25 |
| Last Update Date | 2022-04-15 |