| NPI | 1780122671 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3018663) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 22232) |
| Enumeration Date | 2017-02-10 |
| Last Update Date | 2023-03-09 |