| NPI | 1932544582 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3011119) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 17610) |
| Enumeration Date | 2013-05-08 |
| Last Update Date | 2017-02-28 |