| NPI | 1356826903 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3012744) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KY 1119844) |
| Enumeration Date | 2018-09-29 |
| Last Update Date | 2019-04-13 |