| NPI | 1063860575 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3016301) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: CA 95004392) |
| Enumeration Date | 2016-05-25 |
| Last Update Date | 2021-06-24 |