| NPI | 1104536168 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3018326) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: KY 3018326) |
| Enumeration Date | 2022-11-30 |
| Last Update Date | 2023-01-06 |