| NPI | 1912392432 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WV APRN79056-NP-C) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 3009320) |
| 363LF0000X Nurse Practitioner, Family (Licence: KY 30093200) | |
| Enumeration Date | 2015-04-01 |
| Last Update Date | 2023-11-01 |