| NPI | 1972025732 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WV APRN57339) |
| Additional Taxonomies | 2086S0129X (Licence: WV 20213) |
| Enumeration Date | 2017-07-13 |
| Last Update Date | 2026-02-25 |