| NPI | 1184094120 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11022649) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 3009785) |
| Enumeration Date | 2015-10-02 |
| Last Update Date | 2022-11-10 |