| NPI | 1780070813 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WV 75578) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WV APRN75578-NP-C) |
| Enumeration Date | 2015-04-15 |
| Last Update Date | 2021-10-25 |