| NPI | 1134548514 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: KY 3008479) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: TN 17988) |
| Enumeration Date | 2014-04-14 |
| Last Update Date | 2022-03-29 |