| NPI | 1164051306 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: KY 3013709) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: VA 0024177455) |
| Enumeration Date | 2020-04-08 |
| Last Update Date | 2023-09-22 |