| NPI | 1366783102 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3007997) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 1118146) |
| Enumeration Date | 2013-03-04 |
| Last Update Date | 2024-05-29 |