| NPI | 1912437526 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3015617) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024173816) |
| Enumeration Date | 2017-06-15 |
| Last Update Date | 2023-04-10 |