| NPI | 1538765870 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3015278) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KY 1140298) |
| 363L00000X Nurse Practitioner (Licence: KY 3015278) | |
| Enumeration Date | 2020-12-10 |
| Last Update Date | 2020-12-10 |