| NPI | 1497596209 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 4024228) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WV 119203) |
| Enumeration Date | 2024-06-05 |
| Last Update Date | 2024-08-15 |