| NPI | 1780199638 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3011929) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: KY 3011929) |
| Enumeration Date | 2017-12-13 |
| Last Update Date | 2018-03-17 |