| NPI | 1710429113 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3010878)  | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OH CNP.020944)  | 
| Enumeration Date | 2016-11-16 | 
| Last Update Date | 2020-07-14 |