| NPI | 1770864746 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3013830) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CT 004783) |
| Enumeration Date | 2011-09-06 |
| Last Update Date | 2022-07-11 |