| NPI | 1083141808 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3011250) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 3011250) |
| Enumeration Date | 2017-05-11 |
| Last Update Date | 2021-03-10 |