| NPI | 1639791908 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3016473) |
| Additional Taxonomies | 163WE0003X Registered Nurse, Emergency (Licence: KY 1152614) |
| 363L00000X Nurse Practitioner (Licence: KY 3016473) | |
| Enumeration Date | 2020-05-10 |
| Last Update Date | 2021-11-02 |