| NPI | 1538561113 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3011011) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TN 19136) |
| Enumeration Date | 2014-09-25 |
| Last Update Date | 2020-10-15 |