| NPI | 1588943849 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3007074)  | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KY 1062113)  | 
| Enumeration Date | 2011-08-04 | 
| Last Update Date | 2024-02-13 |