| NPI | 1386351450 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: WV 114566) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: KY 3018466) |
| Enumeration Date | 2022-10-28 |
| Last Update Date | 2023-03-16 |