| NPI | 1841703089 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3011251) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 3011251) |
| Enumeration Date | 2017-11-09 |
| Last Update Date | 2019-03-20 |