| NPI | 1104220482 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3008978) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 3008978) |
| Enumeration Date | 2014-10-15 |
| Last Update Date | 2026-03-18 |