| NPI | 1568702645 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 17413) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 3008271) |
| Enumeration Date | 2013-02-26 |
| Last Update Date | 2020-06-26 |