| NPI | 1538717814 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: KY 3013781) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KY 1148737) |
| Enumeration Date | 2019-08-29 |
| Last Update Date | 2020-11-10 |