| NPI | 1912556507 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WV 105500) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024178151) |
| Enumeration Date | 2019-09-06 |
| Last Update Date | 2022-05-02 |