| NPI | 1053091199 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3018302) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OH 0033120) |
| Enumeration Date | 2023-07-24 |
| Last Update Date | 2023-10-13 |