| NPI | 1730584657 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3009053) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: KY 3009053) |
| Enumeration Date | 2014-11-04 |
| Last Update Date | 2019-03-29 |