| NPI | 1104394246 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3013238) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KY 1131646) |
| Enumeration Date | 2018-11-07 |
| Last Update Date | 2019-03-26 |