| NPI | 1366811796 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3009829) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: KY 3009829) |
| Enumeration Date | 2015-09-16 |
| Last Update Date | 2024-08-29 |