| NPI | 1255118576 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 4009533) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC Ritz-Q8V8N) |
| Enumeration Date | 2023-09-11 |
| Last Update Date | 2023-11-10 |