| NPI | 1922317619 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5014262) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 6622P) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: KY 3006622) | |
| Enumeration Date | 2010-09-29 |
| Last Update Date | 2021-04-02 |