| NPI | 1902441231 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WV 104692) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WV 89429) |
| Enumeration Date | 2019-11-11 |
| Last Update Date | 2022-12-28 |