| NPI | 1750613741 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: KY 33006356) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: KY 6356P) |
| Enumeration Date | 2010-02-02 |
| Last Update Date | 2021-10-06 |