| NPI | 1194074443 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3017626) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AZ AP4652) |
| Enumeration Date | 2012-09-02 |
| Last Update Date | 2022-07-14 |