| NPI | 1407269830 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3008659) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IN 28174694A) |
| Enumeration Date | 2014-06-03 |
| Last Update Date | 2022-02-02 |