| NPI | 1992155832 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WV APRN78414-NP-BC) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WV APRN78414) |
| Enumeration Date | 2016-06-21 |
| Last Update Date | 2022-03-11 |