| NPI | 1720477383 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 19269) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 3009132) |
| Enumeration Date | 2015-01-20 |
| Last Update Date | 2022-03-29 |