| NPI | 1467078840 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: KY 4011431) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner Pediatrics (Licence: TN 27710) |
| Enumeration Date | 2020-06-22 |
| Last Update Date | 2023-11-17 |