| NPI | 1770983785 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3015890) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WV 71599) |
| Enumeration Date | 2014-08-27 |
| Last Update Date | 2021-08-13 |