| NPI | 1164710620 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3007027) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 5023203) |
| Enumeration Date | 2011-07-19 |
| Last Update Date | 2025-11-26 |