| NPI | 1124566641 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: KY 3011106) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN 191551) |
| Enumeration Date | 2017-02-03 |
| Last Update Date | 2024-09-13 |