| NPI | 1710597075 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3015020) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: KY 3015020) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: KY 57174) | |
| Enumeration Date | 2020-08-03 |
| Last Update Date | 2020-09-17 |