| NPI | 1053903054 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3015806) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 3015806) |
| Enumeration Date | 2021-02-10 |
| Last Update Date | 2021-11-03 |