| NPI | 1871098343 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WV 2018000043) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WV 2018000043) |
| Enumeration Date | 2018-03-27 |
| Last Update Date | 2018-05-02 |