| NPI | 1063964971 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3010607) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 3010607) |
| 363LF0000X Nurse Practitioner, Family (Licence: NY 343728) | |
| Enumeration Date | 2016-10-26 |
| Last Update Date | 2023-09-13 |