| NPI | 1912612763 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: IN 71013451A) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: KY 3018888) |
| Enumeration Date | 2023-01-17 |
| Last Update Date | 2024-02-20 |