| NPI | 1780060913 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3010102) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TN 20866) |
| 363L00000X Nurse Practitioner (Licence: VA 0024191340) | |
| Enumeration Date | 2015-08-11 |
| Last Update Date | 2025-11-12 |