| NPI | 1821541889 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WV APRN58862) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WV 58862) |
| 363LF0000X Nurse Practitioner, Family (Licence: VA 0024173776) | |
| Enumeration Date | 2016-07-26 |
| Last Update Date | 2024-03-29 |