| NPI | 1659628469 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3007526) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: KY 3007526) |
| 363LF0000X Nurse Practitioner, Family (Licence: KY 3007526) | |
| Enumeration Date | 2012-08-10 |
| Last Update Date | 2020-10-26 |