| NPI | 1790224699 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3011085) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 24728) |
| Enumeration Date | 2017-02-13 |
| Last Update Date | 2019-04-04 |