| NPI | 1205380664 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3009295) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KY 1108570) |
| Enumeration Date | 2016-08-15 |
| Last Update Date | 2025-08-27 |