| NPI | 1184267494 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11019187) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 1142857) |
| Enumeration Date | 2019-10-21 |
| Last Update Date | 2025-01-21 |