| NPI | 1679923825 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN9486045) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 3010264) |
| Enumeration Date | 2016-06-20 |
| Last Update Date | 2021-08-16 |