| NPI | 1205164936 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3006271) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 6271P) |
| Enumeration Date | 2009-11-18 |
| Last Update Date | 2023-01-11 |