| NPI | 1790020469 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: KY 3018000) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KY 1155246) |
| 246Z00000X Specialist/Technologist, Other | |
| 363LF0000X Nurse Practitioner Family (Licence: KY 1155246) | |
| Enumeration Date | 2012-12-06 |
| Last Update Date | 2022-09-19 |