| NPI | 1104495928 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3017110) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IN 71012111A) |
| 363LF0000X Nurse Practitioner, Family (Licence: OH 0029132) | |
| Enumeration Date | 2021-06-24 |
| Last Update Date | 2025-04-03 |