| NPI | 1548809262 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3013765) |
| Additional Taxonomies | 2085B0100X Radiology, Body Imaging (Licence: KY 10839) |
| 363L00000X Nurse Practitioner (Licence: KY 3013765) | |
| Enumeration Date | 2019-12-27 |
| Last Update Date | 2021-09-25 |