| NPI | 1295201432 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3012777) |
| Additional Taxonomies | 208D00000X General Practice (Licence: KY 3012777) |
| Enumeration Date | 2018-10-15 |
| Last Update Date | 2019-08-08 |