| NPI | 1285303321 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NM 65639) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 3016528) |
| Enumeration Date | 2021-09-11 |
| Last Update Date | 2021-12-07 |