| NPI | 1255687539 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WV 83820) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 3008219) |
| Enumeration Date | 2012-07-24 |
| Last Update Date | 2025-07-10 |