| NPI | 1609417211 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3013797) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KY 1145205) |
| Enumeration Date | 2019-10-04 |
| Last Update Date | 2020-01-06 |