| NPI | 1316985492 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL 11010345) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 3002296) |
| Enumeration Date | 2006-06-02 |
| Last Update Date | 2021-09-21 |