| NPI | 1154987451 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| 261QR1300X Clinic/Center, Rural Health | |
| 261QU0200X Clinic/Center, Urgent Care | |
| 207Q00000X Family Medicine (Licence: KY 3013338) | |
| 363LF0000X Nurse Practitioner, Family (Licence: KY 3013338) | |
| Enumeration Date | 2019-05-13 |
| Last Update Date | 2025-05-03 |