| NPI | 1619250131 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: KY 3007138) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: IA A130173) |
| Enumeration Date | 2011-09-21 |
| Last Update Date | 2022-09-27 |