| NPI | 1245764240 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3015609) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN APN22054) |
| Enumeration Date | 2017-04-17 |
| Last Update Date | 2021-03-05 |