| NPI | 1114688439 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 10016062) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 3017163) |
| Enumeration Date | 2022-01-08 |
| Last Update Date | 2023-10-20 |