| NPI | 1245328319 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3003027) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 2032) |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2019-08-09 |