| NPI | 1184429524 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: KY 4033736) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 4033736) | 
| Enumeration Date | 2025-02-18 | 
| Last Update Date | 2025-02-18 |