| NPI | 1063954121 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3011357) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: KY 3011357) |
| 163W00000X Registered Nurse (Licence: KY 1091604) | |
| Enumeration Date | 2016-11-07 |
| Last Update Date | 2022-05-06 |