| NPI | 1245919596 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 4009976) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KY 1142802) |
| Enumeration Date | 2023-07-13 |
| Last Update Date | 2023-10-05 |