| NPI | 1760046387 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: KY 3018673) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WV 102693) |
| Enumeration Date | 2019-04-29 |
| Last Update Date | 2022-11-10 |