| NPI | 1497990303 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3005892) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 5892P) |
| Enumeration Date | 2008-12-05 |
| Last Update Date | 2023-09-18 |