| NPI | 1851863096 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024176977) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WV APRN39171NP) |
| Enumeration Date | 2018-12-28 |
| Last Update Date | 2018-12-28 |