| NPI | 1467809327 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3011263) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 00000) |
| Enumeration Date | 2016-05-20 |
| Last Update Date | 2020-12-08 |