| NPI | 1215642459 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 4026971) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN 266159) |
| 363LF0000X Nurse Practitioner, Family (Licence: NC 5018722) | |
| Enumeration Date | 2023-01-23 |
| Last Update Date | 2024-10-01 |