| NPI | 1336805662 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3016914) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 30450) |
| Enumeration Date | 2021-11-10 |
| Last Update Date | 2022-06-22 |