| NPI | 1588830749 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3007734) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AZ AP8845) |
| 363LF0000X Nurse Practitioner, Family (Licence: KY 3007734) | |
| Enumeration Date | 2008-05-07 |
| Last Update Date | 2019-03-11 |