| NPI | 1063034312 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3015443) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KY 1126411) |
| 363LF0000X Nurse Practitioner, Family (Licence: KY 3015443) | |
| Enumeration Date | 2020-05-09 |
| Last Update Date | 2023-08-28 |