| NPI | 1861883779 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 19662) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 3016035) |
| Enumeration Date | 2015-02-13 |
| Last Update Date | 2022-10-19 |