| NPI | 1134790421 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3017311)  | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL APRN11013880)  | 
| Enumeration Date | 2021-07-07 | 
| Last Update Date | 2022-05-27 |