| NPI | 1225631823 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MD R259382) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 3014287) |
| Enumeration Date | 2020-11-17 |
| Last Update Date | 2023-05-15 |