| NPI | 1912603937 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 4051623) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WV 115545) |
| Enumeration Date | 2023-02-01 |
| Last Update Date | 2026-08-18 |