| NPI | 1982958229 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3007832) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 3007832) |
| Enumeration Date | 2012-11-08 |
| Last Update Date | 2019-05-28 |