| NPI | 1245803899 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3017213) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 59864) |
| Enumeration Date | 2021-07-21 |
| Last Update Date | 2022-07-12 |