| NPI | 1265962799 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3011490) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KY 1136226) |
| Enumeration Date | 2017-06-18 |
| Last Update Date | 2021-11-17 |