| NPI | 1750364519 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 21784) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 4558P) |
| Enumeration Date | 2005-11-26 |
| Last Update Date | 2020-06-17 |