| NPI | 1134673015 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3011627) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WV APRN74130-NP-C) |
| Enumeration Date | 2016-08-09 |
| Last Update Date | 2021-11-19 |