| NPI | 1407458920 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3015194) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IN 71011015A) |
| Enumeration Date | 2020-11-10 |
| Last Update Date | 2022-05-17 |