| NPI | 1598239287 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3012961) |
| Additional Taxonomies | 261QU0200X Clinic/Center, Urgent Care (Licence: KY 3012961) |
| Enumeration Date | 2019-01-15 |
| Last Update Date | 2019-01-24 |