| NPI | 1982254967 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3013485) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WV 103665) |
| Enumeration Date | 2019-09-12 |
| Last Update Date | 2023-09-18 |