| NPI | 1215333133 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3009069) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 3009069) |
| Enumeration Date | 2014-11-05 |
| Last Update Date | 2019-05-30 |