| NPI | 1124702709 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 4002212) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IN 71015569A) |
| 363LF0000X Nurse Practitioner, Family (Licence: KY 4002212) | |
| Enumeration Date | 2023-06-14 |
| Last Update Date | 2024-09-11 |