| NPI | 1720446263 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3010192) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 95003759) |
| Enumeration Date | 2016-01-28 |
| Last Update Date | 2017-02-16 |