| NPI | 1194360446 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3014655) | 
| Additional Taxonomies | 163WL0100X Registered Nurse, Lactation Consultant (Licence: KY L-47082) | 
| 363LF0000X Nurse Practitioner, Family (Licence: TN 28172) | |
| Enumeration Date | 2019-11-11 | 
| Last Update Date | 2024-05-27 |