| NPI | 1659947661 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3016202) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 27319) |
| Enumeration Date | 2021-06-01 |
| Last Update Date | 2021-06-08 |