| NPI | 1558920488 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3013526) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 1112298) |
| Enumeration Date | 2019-06-13 |
| Last Update Date | 2019-11-21 |