| NPI | 1912364118 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WV APRN68811) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WV 68811) |
| Enumeration Date | 2016-01-20 |
| Last Update Date | 2021-11-24 |