| NPI | 1063826840 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3016307) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 18794) |
| 363LF0000X Nurse Practitioner, Family (Licence: OH 0031132) | |
| Enumeration Date | 2014-06-19 |
| Last Update Date | 2022-06-09 |