| NPI | 1528624905 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3013256) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 3013256) |
| Enumeration Date | 2019-05-11 |
| Last Update Date | 2021-03-04 |