| NPI | 1699029462 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 19111) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 3007739) |
| Enumeration Date | 2012-11-01 |
| Last Update Date | 2022-05-25 |