| NPI | 1790399236 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3015103) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 57107) |
| Enumeration Date | 2020-09-02 |
| Last Update Date | 2024-07-22 |