| NPI | 1609494269 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3015578) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WV 2020009385) |
| Enumeration Date | 2020-07-10 |
| Last Update Date | 2021-01-06 |