| NPI | 1639886740 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 4007192) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: WV 114352) |
| Enumeration Date | 2022-10-31 |
| Last Update Date | 2023-10-20 |