| NPI | 1821517921 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3011698) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 3011698) |
| Enumeration Date | 2017-09-11 |
| Last Update Date | 2020-09-16 |