| NPI | 1699640565 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WV 124087) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 4046364) |
| Enumeration Date | 2025-10-09 |
| Last Update Date | 2026-05-01 |