| NPI | 1669773511 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3006687) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 3003387) |
| Enumeration Date | 2010-11-09 |
| Last Update Date | 2020-12-07 |