| NPI | 1164172292 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3017513) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KY 1169778) |
| Enumeration Date | 2022-03-23 |
| Last Update Date | 2022-05-06 |