| NPI | 1255832630 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3012062) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WV 99113) |
| 163W00000X Registered Nurse (Licence: OH 391374) | |
| 163W00000X Registered Nurse (Licence: KY 1074151) | |
| Enumeration Date | 2018-02-22 |
| Last Update Date | 2018-02-22 |