| NPI | 1760027254 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WV 110359) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: VA 0024182440) |
| 363LF0000X Nurse Practitioner, Family (Licence: TX AP143515) | |
| Enumeration Date | 2019-11-08 |
| Last Update Date | 2021-12-01 |