| NPI | 1700471174 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3015929) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: KY F03210319) |
| Enumeration Date | 2021-03-07 |
| Last Update Date | 2024-01-08 |