| NPI | 1376125617 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TN 29224) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 3016049) |
| Enumeration Date | 2021-04-26 |
| Last Update Date | 2021-10-18 |