| NPI | 1982128526 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3011580)  | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 3011580)  | 
| Enumeration Date | 2017-07-26 | 
| Last Update Date | 2021-09-27 |