| NPI | 1457969040 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: KY 3016928) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: WV 107013) |
| Enumeration Date | 2020-07-20 |
| Last Update Date | 2021-11-10 |