| NPI | 1770176992 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: KY 3015203) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 3015203) |
| Enumeration Date | 2021-02-18 |
| Last Update Date | 2021-03-30 |