| NPI | 1417321779 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 20621) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: KY 3013269) |
| Enumeration Date | 2015-11-23 |
| Last Update Date | 2019-04-12 |