| NPI | 1073018040 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: SC 29402) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 3012211) |
| Enumeration Date | 2018-03-29 |
| Last Update Date | 2025-06-25 |