| NPI | 1134092307 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: KY 4046410) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: KY 4046410) |
| Enumeration Date | 2025-09-24 |
| Last Update Date | 2025-09-24 |