| NPI | 1922496090 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3009287) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN 203251) |
| 363LF0000X Nurse Practitioner, Family (Licence: KY 3009287) | |
| Enumeration Date | 2014-12-24 |
| Last Update Date | 2018-02-09 |