| NPI | 1639834187 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: KY 3016906) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: KY F10210325) |
| Enumeration Date | 2021-11-01 |
| Last Update Date | 2021-12-08 |