| NPI | 1497358899 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3016050) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: SC 24309) |
| Enumeration Date | 2020-11-18 |
| Last Update Date | 2021-09-23 |