| NPI | 1619338993 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: KY 3010272) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: OH COA.18905-NP) |
| Enumeration Date | 2016-03-14 |
| Last Update Date | 2021-01-08 |