| NPI | 1154063790 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3018993) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 31082) |
| Enumeration Date | 2022-04-13 |
| Last Update Date | 2023-02-21 |