| NPI | 1346870458 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3014216) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KY 3014216) |
| Enumeration Date | 2020-01-17 |
| Last Update Date | 2021-08-11 |