| NPI | 1164064101 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3013937) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 3013937) |
| Enumeration Date | 2019-10-10 |
| Last Update Date | 2023-05-18 |