| NPI | 1851936629 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WV 104796) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: WV 104796) |
| Enumeration Date | 2019-11-15 |
| Last Update Date | 2021-02-27 |