| NPI | 1225857550 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 4029011) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KY 1165566) |
| Enumeration Date | 2024-10-03 |
| Last Update Date | 2025-12-13 |