| NPI | 1053704403 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3009261) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 19863) |
| Enumeration Date | 2015-03-10 |
| Last Update Date | 2024-05-20 |