| NPI | 1265901649 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 35615) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 3012680) |
| Enumeration Date | 2018-11-15 |
| Last Update Date | 2026-08-04 |