| NPI | 1972800712 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3006696) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KY 1105950) |
| Enumeration Date | 2011-02-14 |
| Last Update Date | 2024-03-07 |