| NPI | 1013679547 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WV 116062) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 3014734) |
| Enumeration Date | 2021-10-12 |
| Last Update Date | 2024-01-04 |