| NPI | 1992064463 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2012010244) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 3017827) |
| Enumeration Date | 2012-05-03 |
| Last Update Date | 2022-06-20 |