| NPI | 1972259075 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5017391) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WV 112168) |
| Enumeration Date | 2022-02-28 |
| Last Update Date | 2023-03-03 |