| NPI | 1063933877 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3011429) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 3011429) |
| Enumeration Date | 2017-06-30 |
| Last Update Date | 2019-09-09 |