| NPI | 1972014538 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: NC 5009991) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KY 1146175) |
| 363LF0000X Nurse Practitioner Family (Licence: KY 3011685) | |
| Enumeration Date | 2017-10-22 |
| Last Update Date | 2017-10-22 |