| NPI | 1740649557 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3010132) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WV 75708) |
| Enumeration Date | 2016-02-22 |
| Last Update Date | 2019-09-09 |