| NPI | 1316658842 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3018746) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704408799) |
| 363LF0000X Nurse Practitioner, Family (Licence: CT 15545) | |
| 363LF0000X Nurse Practitioner, Family (Licence: CA 95035357) | |
| 363LF0000X Nurse Practitioner, Family (Licence: TX 1197262) | |
| 363L00000X Nurse Practitioner (Licence: KY 3018746) | |
| 363LF0000X Nurse Practitioner, Family (Licence: IL 209030019) | |
| Enumeration Date | 2022-12-06 |
| Last Update Date | 2025-10-21 |