| NPI | 1811624901 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WV 113684) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WV 113864) |
| Enumeration Date | 2022-08-08 |
| Last Update Date | 2025-01-16 |