| NPI | 1922554583 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL APRN11001343) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: WV APRN79913-NP-C) |
| Enumeration Date | 2016-09-01 |
| Last Update Date | 2021-09-17 |