| NPI | 1730883141 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WV 80735) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WV 80735) |
| 207Q00000X Family Medicine (Licence: WV 80735) | |
| Enumeration Date | 2023-03-29 |
| Last Update Date | 2024-04-26 |