| NPI | 1134616410 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3011912) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 342904) |
| 363L00000X Nurse Practitioner (Licence: IN 71010651A) | |
| Enumeration Date | 2018-04-22 |
| Last Update Date | 2021-06-28 |