| NPI | 1568013696 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3013257) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KY 1146075) |
| Enumeration Date | 2019-09-20 |
| Last Update Date | 2022-03-15 |