| NPI | 1336139153 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 7420) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 2707P) |
| Enumeration Date | 2005-10-24 |
| Last Update Date | 2023-03-07 |