| NPI | 1952689598 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LW0102X Nurse Practitioner, Women's Health (Licence: KY 3006656) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 3006656) |
| 363LW0102X Nurse Practitioner, Women's Health (Licence: WV 79871) | |
| Enumeration Date | 2011-08-01 |
| Last Update Date | 2020-04-29 |