| NPI | 1376211656 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: KY 3016306) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KY 1147215) |
| Enumeration Date | 2021-09-01 |
| Last Update Date | 2021-09-01 |