| NPI | 1942780507 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: VA 0024179430) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 3012595) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: KY 3012595) | |
| Enumeration Date | 2018-08-14 |
| Last Update Date | 2023-06-28 |