| NPI | 1316506298 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LW0102X Nurse Practitioner, Women's Health (Licence: KY 3013456) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 3013456) |
| Enumeration Date | 2019-06-13 |
| Last Update Date | 2020-02-25 |