| NPI | 1245648542 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 9490444) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 3008797) |
| Enumeration Date | 2014-07-30 |
| Last Update Date | 2020-01-29 |