| NPI | 1669817219 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3008004) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 17602) |
| Enumeration Date | 2013-05-08 |
| Last Update Date | 2019-12-20 |