| NPI | 1215135991 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3005253) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 3005253) |
| Enumeration Date | 2007-07-05 |
| Last Update Date | 2024-04-10 |