| NPI | 1588019210 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 21147) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY F1215489) |
| Enumeration Date | 2016-05-02 |
| Last Update Date | 2016-05-25 |