| NPI | 1780067611 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WV APRN81216-FNP-BC) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WV 81216) |
| Enumeration Date | 2015-07-09 |
| Last Update Date | 2021-11-17 |