| NPI | 1568865079 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 18859) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 3008713) |
| Enumeration Date | 2014-09-29 |
| Last Update Date | 2019-11-20 |