| NPI | 1639634199 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3012962) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IN 71010695A) |
| Enumeration Date | 2019-02-08 |
| Last Update Date | 2020-12-30 |