| NPI | 1255955654 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3014831) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 57196) |
| Enumeration Date | 2020-06-01 |
| Last Update Date | 2021-06-09 |