| NPI | 1548663230 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3016429) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 19199) |
| Enumeration Date | 2014-10-08 |
| Last Update Date | 2021-09-22 |