| NPI | 1508380478 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3011683) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CO 0000855-C-NP) |
| Enumeration Date | 2017-08-01 |
| Last Update Date | 2019-09-20 |