| NPI | 1174754485 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3006100) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 5023743) |
| 363LF0000X Nurse Practitioner, Family (Licence: SC 31410) | |
| 363LF0000X Nurse Practitioner, Family (Licence: OH 0038148) | |
| Enumeration Date | 2009-08-04 |
| Last Update Date | 2026-02-06 |