| NPI | 1770902967 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3012550) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KY 1124212) |
| Enumeration Date | 2014-04-15 |
| Last Update Date | 2024-03-22 |