| NPI | 1063173417 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3018714) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 11017283) |
| Enumeration Date | 2022-01-07 |
| Last Update Date | 2023-05-08 |