| NPI | 1720054240 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3004674) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 1099054) |
| Enumeration Date | 2006-02-24 |
| Last Update Date | 2023-03-01 |