| NPI | 1609439397 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3013311) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 3013311) |
| Enumeration Date | 2019-04-17 |
| Last Update Date | 2023-01-09 |