| NPI | 1902307598 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 21224) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 3011543) |
| Enumeration Date | 2018-02-28 |
| Last Update Date | 2024-01-11 |