| NPI | 1619024064 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3009958) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN136073) |
| Enumeration Date | 2007-01-05 |
| Last Update Date | 2020-06-22 |