| NPI | 1467947267 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 28977) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 3012499) | 
| Enumeration Date | 2018-06-25 | 
| Last Update Date | 2022-11-01 |