| NPI | 1396182119 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: KY 3008076) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 3008076) |
| Enumeration Date | 2013-06-03 |
| Last Update Date | 2020-04-27 |