| NPI | 1841877313 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3016104) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KY 1141037) |
| Enumeration Date | 2021-03-29 |
| Last Update Date | 2021-05-14 |