| NPI | 1679127930 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3014870) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: OH CNP025231) |
| Enumeration Date | 2019-07-25 |
| Last Update Date | 2020-08-13 |