| NPI | 1578508180 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3003817) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WV 54195) |
| Enumeration Date | 2006-06-18 |
| Last Update Date | 2018-10-30 |