| NPI | 1508218314 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3010420) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KY 1110594) |
| Enumeration Date | 2016-07-05 |
| Last Update Date | 2021-11-15 |