| NPI | 1902370497 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WV APRN97879NP) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: VA 0024176995) |
| Enumeration Date | 2019-01-17 |
| Last Update Date | 2022-04-21 |