| NPI | 1942567763 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: WV APRN63168) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WV 63168) |
| Enumeration Date | 2012-04-18 |
| Last Update Date | 2024-07-17 |