| NPI | 1104557255 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3017904) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 3017904) |
| Enumeration Date | 2022-06-20 |
| Last Update Date | 2023-08-14 |