| NPI | 1407490584 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3014017) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KY 1132166) |
| Enumeration Date | 2019-11-01 |
| Last Update Date | 2020-12-07 |