| NPI | 1609279082 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 9467859) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 3008973) |
| 363LF0000X Nurse Practitioner, Family (Licence: KY 3008973) | |
| Enumeration Date | 2014-09-30 |
| Last Update Date | 2019-12-03 |