| NPI | 1548823628 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WV 105700) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 4019424) |
| Enumeration Date | 2019-04-15 |
| Last Update Date | 2025-01-02 |