| NPI | 1194564211 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 4026740) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KY 1121119) |
| Enumeration Date | 2024-05-20 |
| Last Update Date | 2024-08-25 |