| NPI | 1972263242 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: WV 110316) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: WV 75789) |
| Enumeration Date | 2021-12-28 |
| Last Update Date | 2023-08-09 |