| NPI | 1053660316 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3009632) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 16953) |
| Enumeration Date | 2012-09-02 |
| Last Update Date | 2023-08-02 |