| NPI | 1811577539 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WV 107732) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WV 56798) |
| 163W00000X Registered Nurse (Licence: OH 279858) | |
| Enumeration Date | 2021-04-08 |
| Last Update Date | 2024-07-10 |