| NPI | 1740805407 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3014712) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KY 1135351) |
| Enumeration Date | 2020-06-09 |
| Last Update Date | 2020-06-20 |