| NPI | 1154931202 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3014939) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY F06202521) |
| Enumeration Date | 2020-08-04 |
| Last Update Date | 2021-03-23 |