| NPI | 1174138713 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: VA 0024183683) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 3014982) |
| Enumeration Date | 2020-09-10 |
| Last Update Date | 2023-01-06 |