| NPI | 1710722004 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 4027071) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WV 120216) |
| Enumeration Date | 2024-06-27 |
| Last Update Date | 2024-09-27 |