| NPI | 1902376528 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WV APRN83669-FNP-BC) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WV 83669) |
| Enumeration Date | 2018-11-26 |
| Last Update Date | 2021-11-05 |