| NPI | 1730617465 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 176494) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WV 103575) |
| Enumeration Date | 2017-05-25 |
| Last Update Date | 2023-02-09 |