| NPI | 1720616196 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WV 125688) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 3017487) |
| 363L00000X Nurse Practitioner (Licence: FL APRN11004302) | |
| Enumeration Date | 2020-03-31 |
| Last Update Date | 2026-04-30 |