| NPI | 1730641879 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: KY 3013210) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 3013210) |
| 363LP2300X Nurse Practitioner Primary Care (Licence: KY 3013210) | |
| Enumeration Date | 2019-04-05 |
| Last Update Date | 2024-02-15 |