| NPI | 1023576337 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3013204) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KY 3013204) |
| Enumeration Date | 2019-03-05 |
| Last Update Date | 2023-04-12 |