| NPI | 1073036786 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3016609) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 22813) |
| Enumeration Date | 2017-07-25 |
| Last Update Date | 2021-09-15 |