| NPI | 1174964969 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: KY 3008160) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 3008160) |
| Enumeration Date | 2013-07-09 |
| Last Update Date | 2021-03-22 |