| NPI | 1881251866 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3012268) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 3012268) |
| Enumeration Date | 2019-05-24 |
| Last Update Date | 2022-03-08 |