| NPI | 1962024257 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WV 105148) |
| Additional Taxonomies | 163WR0006X Registered Nurse, Registered Nurse First Assistant (Licence: WV 105148) |
| 363L00000X Nurse Practitioner (Licence: KY 3014474) | |
| 363LF0000X Nurse Practitioner, Family (Licence: KY 3014474) | |
| Enumeration Date | 2020-05-11 |
| Last Update Date | 2022-08-12 |