| NPI | 1598310419 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3014435) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TN 26332) |
| Enumeration Date | 2019-08-07 |
| Last Update Date | 2021-03-04 |