| NPI | 1992210165 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3012355) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KY 112721) |
| Enumeration Date | 2017-12-08 |
| Last Update Date | 2023-08-15 |