| NPI | 1649897497 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3015348) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN 240752) |
| 363L00000X Nurse Practitioner (Licence: KY 3015348) | |
| 363LF0000X Nurse Practitioner, Family (Licence: TN 28531) | |
| Enumeration Date | 2020-06-28 |
| Last Update Date | 2021-12-22 |