| NPI | 1295496677 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3016093)  | 
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: KY 3016093)  | 
| Enumeration Date | 2022-01-06 | 
| Last Update Date | 2023-02-07 |