| NPI | 1407631252 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: KY 3015841) |
| Additional Taxonomies | 208D00000X General Practice (Licence: KY 3015841) |
| Enumeration Date | 2023-08-29 |
| Last Update Date | 2023-11-01 |