| NPI | 1700861853 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3004023) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: KY 4023P) |
| Enumeration Date | 2005-12-13 |
| Last Update Date | 2020-10-13 |