| NPI | 1255483558 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: KY 3004741) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: KY 4741P) |
| Enumeration Date | 2007-01-17 |
| Last Update Date | 2022-05-18 |