| NPI | 1487110003 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MD R257152) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 3012714) |
| Enumeration Date | 2019-02-19 |
| Last Update Date | 2023-11-21 |