| NPI | 1912464884 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WV 104039) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001246103) |
| 363LF0000X Nurse Practitioner, Family (Licence: VA 0024176964) | |
| Enumeration Date | 2019-02-26 |
| Last Update Date | 2024-01-16 |