| NPI | 1770137580 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WV 103703) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OR 10028859) |
| Enumeration Date | 2019-07-30 |
| Last Update Date | 2025-10-21 |