| NPI | 1174653471 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3004438) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 3004438) |
| 363LF0000X Nurse Practitioner, Family (Licence: KY F1004066) | |
| Enumeration Date | 2007-03-06 |
| Last Update Date | 2026-08-13 |