| NPI | 1073498044 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: KY 4046117) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KY 1136684) |
| Enumeration Date | 2025-08-08 |
| Last Update Date | 2025-09-29 |