| NPI | 1376010892 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NE 113859) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 3012851) |
| Enumeration Date | 2018-11-01 |
| Last Update Date | 2022-09-13 |