| NPI | 1811419013 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MD AC003966) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WV APRN54751-NP-C) |
| Enumeration Date | 2017-07-10 |
| Last Update Date | 2023-04-18 |