| NPI | 1821449943 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3010341) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: KY 3010341) |
| Enumeration Date | 2016-06-30 |
| Last Update Date | 2021-09-21 |