| NPI | 1861098212 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: KY 3015446) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 3015446) |
| Enumeration Date | 2020-12-10 |
| Last Update Date | 2022-03-13 |