| NPI | 1609351519 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: WV APRN62225) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: WV 62225) |
| 363LF0000X Nurse Practitioner Family (Licence: KY 3102767) | |
| Enumeration Date | 2018-09-26 |
| Last Update Date | 2024-10-09 |