| NPI | 1760886550 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11002018) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 3010291) |
| Enumeration Date | 2014-10-22 |
| Last Update Date | 2022-07-25 |