| NPI | 1750002317 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WV 114398) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WV 83402) |
| 363L00000X Nurse Practitioner (Licence: WV 114398) | |
| Enumeration Date | 2022-09-12 |
| Last Update Date | 2022-11-16 |