| NPI | 1194394320 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3016484) |
| Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: KY 1128783) |
| Enumeration Date | 2021-06-22 |
| Last Update Date | 2021-08-20 |