| NPI | 1730629809 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: VA 0024183763) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WV APRN90146) |
| Enumeration Date | 2017-03-08 |
| Last Update Date | 2023-07-28 |