| NPI | 1104431543 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3013678) |
| Additional Taxonomies | 207QA0401X Family Medicine, Addiction Medicine (Licence: KY 3013678) |
| 363L00000X Nurse Practitioner (Licence: KY 3013678) | |
| Enumeration Date | 2020-09-12 |
| Last Update Date | 2020-11-16 |