| NPI | 1205313988 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3012150) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AZ 303184) |
| Enumeration Date | 2018-07-25 |
| Last Update Date | 2024-02-08 |