| NPI | 1902293723 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WV APRN68679NP) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024176599) |
| Enumeration Date | 2015-04-20 |
| Last Update Date | 2019-04-26 |