| NPI | 1972192136 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: WV 106873) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WV 106873) |
| 208M00000X Hospitalist (Licence: WV 106873) | |
| Enumeration Date | 2021-01-12 |
| Last Update Date | 2022-04-07 |