| NPI | 1912419383 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WV APRN90483) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH 349075) |
| 363LF0000X Nurse Practitioner, Family (Licence: PA SP022061) | |
| Enumeration Date | 2017-10-25 |
| Last Update Date | 2025-09-12 |