| NPI | 1396426805 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 4008709) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 11428832) |
| Enumeration Date | 2023-07-27 |
| Last Update Date | 2023-11-08 |