| NPI | 1891476644 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA SP030373) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 4007193) |
| Enumeration Date | 2023-07-25 |
| Last Update Date | 2024-09-10 |