| NPI | 1679751069 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3012871) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NY 341165) |
| Enumeration Date | 2008-02-07 |
| Last Update Date | 2021-09-02 |