| NPI | 1487128807 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3013130) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 1144942) |
| Enumeration Date | 2019-01-18 |
| Last Update Date | 2019-03-15 |