| NPI | 1013649631 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3018011) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 1147653) |
| 163W00000X Registered Nurse (Licence: KY 1147653) | |
| Enumeration Date | 2022-06-30 |
| Last Update Date | 2022-06-30 |