| NPI | 1073243325 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WV 113673) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 3015582) |
| Enumeration Date | 2022-06-10 |
| Last Update Date | 2022-08-19 |