| NPI | 1154905008 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3015076) | 
| Additional Taxonomies | 363LX0106X Nurse Practitioner, Occupational Health (Licence: KY 3015076) | 
| Enumeration Date | 2021-05-07 | 
| Last Update Date | 2022-09-08 |