| NPI | 1295101186 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3009339) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WV 101120) |
| Enumeration Date | 2015-08-14 |
| Last Update Date | 2024-05-13 |