| NPI | 1750035556 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TN 29847) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 3016284) |
| Enumeration Date | 2022-02-09 |
| Last Update Date | 2022-02-09 |