| NPI | 1346658663 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 18952) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 3010393) |
| Enumeration Date | 2014-07-30 |
| Last Update Date | 2019-04-16 |