| NPI | 1972091981 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3012818) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 3012818) |
| 163W00000X Registered Nurse (Licence: KY 1118656) | |
| Enumeration Date | 2018-04-25 |
| Last Update Date | 2018-11-08 |