| NPI | 1124688676 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3017373) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 25719) |
| Enumeration Date | 2019-06-17 |
| Last Update Date | 2022-02-22 |