| NPI | 1457992935 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: KY 3015456) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: TN 26621) |
| Enumeration Date | 2019-10-04 |
| Last Update Date | 2022-01-12 |