| NPI | 1689084030 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3008633) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 3008633) |
| Enumeration Date | 2014-05-06 |
| Last Update Date | 2022-01-05 |