| NPI | 1629556980 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: TN 25311) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: KY 3012515) |
| Enumeration Date | 2018-07-30 |
| Last Update Date | 2020-02-10 |