| NPI | 1730517749 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TN 22674) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 3008129) |
| Enumeration Date | 2013-10-30 |
| Last Update Date | 2023-06-19 |