| NPI | 1891251146 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3013012) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 3013012) |
| Enumeration Date | 2019-02-12 |
| Last Update Date | 2021-12-16 |