| NPI | 1902951429 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 086348) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 3013333) |
| Enumeration Date | 2007-01-24 |
| Last Update Date | 2021-03-04 |