| NPI | 1720462252 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3011778) |
| Additional Taxonomies | 163WR0006X Registered Nurse, Registered Nurse First Assistant (Licence: KY 00000) |
| Enumeration Date | 2015-07-14 |
| Last Update Date | 2018-04-27 |