| NPI | 1063885408 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3009866) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: KY 3009866) |
| Enumeration Date | 2015-11-06 |
| Last Update Date | 2018-09-11 |