| NPI | 1104436146 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3013490) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IN 71011085A) |
| 363L00000X Nurse Practitioner (Licence: KY 3013490) | |
| Enumeration Date | 2020-08-04 |
| Last Update Date | 2023-11-07 |