| NPI | 1568913721 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WV 62590) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 3015877) |
| 363L00000X Nurse Practitioner (Licence: FL APRN9497598) | |
| 363LF0000X Nurse Practitioner, Family (Licence: GA 241401) | |
| 363LF0000X Nurse Practitioner, Family (Licence: SC 20454) | |
| Enumeration Date | 2016-10-21 |
| Last Update Date | 2021-06-07 |