| NPI | 1568026243 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WV 103189) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 3013294) |
| Enumeration Date | 2019-04-27 |
| Last Update Date | 2024-08-26 |