| NPI | 1003645441 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 4058930) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KY 1165862) |
| Enumeration Date | 2024-08-01 |
| Last Update Date | 2026-05-27 |