| NPI | 1396139119 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3009302) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 3009302) |
| 363LF0000X Nurse Practitioner, Family (Licence: SC 19990) | |
| Enumeration Date | 2015-03-19 |
| Last Update Date | 2024-03-27 |