| NPI | 1639536972 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: KY 3010014) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 3010014) |
| 363LF0000X Nurse Practitioner, Family (Licence: KY 3010014) | |
| Enumeration Date | 2016-01-18 |
| Last Update Date | 2023-07-27 |