| NPI | 1700419090 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 27163) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 1158104) |
| Enumeration Date | 2020-02-15 |
| Last Update Date | 2020-02-27 |