| NPI | 1679038624 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3012943) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KY 1131177) |
| Enumeration Date | 2019-02-04 |
| Last Update Date | 2019-02-21 |