| NPI | 1497179477 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3008431) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 3008431) |
| Enumeration Date | 2014-02-11 |
| Last Update Date | 2019-10-23 |