| NPI | 1922653609 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3013729) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 1117750) |
| Enumeration Date | 2019-08-08 |
| Last Update Date | 2022-09-21 |