| NPI | 1851017610 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3018455)  | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY F09221219)  | 
| Enumeration Date | 2022-10-13 | 
| Last Update Date | 2022-10-19 |