| NPI | 1871133488 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WV 106009) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WV F12190801) |
| Enumeration Date | 2020-01-11 |
| Last Update Date | 2022-04-20 |