| NPI | 1720535040 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3010708) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 0000021575) |
| Enumeration Date | 2016-09-02 |
| Last Update Date | 2020-02-05 |