| NPI | 1770254302 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: KY 3017482) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: NC 5015096) |
| Enumeration Date | 2021-09-23 |
| Last Update Date | 2023-08-14 |