| NPI | 1588183156 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3011843) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: VA 0024183241) |
| Enumeration Date | 2017-09-15 |
| Last Update Date | 2021-12-08 |