| NPI | 1790191286 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WV APRN73111NP) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WV 73111) |
| Enumeration Date | 2014-07-07 |
| Last Update Date | 2022-10-13 |