| NPI | 1245827658 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: KY 1131932) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 3016446) |
| Enumeration Date | 2020-12-31 |
| Last Update Date | 2021-09-01 |