| NPI | 1982279527 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 10001383) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WV 78217) |
| 363LF0000X Nurse Practitioner, Family (Licence: WV 109979) | |
| Enumeration Date | 2021-05-25 |
| Last Update Date | 2022-12-22 |