| NPI | 1669701736 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 201500367NP-PP) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 3006255) |
| Enumeration Date | 2009-12-18 |
| Last Update Date | 2020-06-04 |