| NPI | 1689815862 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3009101) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 13919) |
| Enumeration Date | 2009-03-17 |
| Last Update Date | 2023-09-19 |