| NPI | 1003230731 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3008346) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 3008346) |
| 363LW0102X Nurse Practitioner, Women's Health (Licence: KY 3008346) | |
| Enumeration Date | 2014-02-17 |
| Last Update Date | 2021-03-05 |