| NPI | 1174144679 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3016964) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KY 1158959) |
| Enumeration Date | 2020-05-06 |
| Last Update Date | 2022-05-24 |