| NPI | 1013343276 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3016796) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2013028538) |
| Enumeration Date | 2013-09-19 |
| Last Update Date | 2021-10-11 |