| NPI | 1487535563 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: KY 4042839) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: KY 4042839) |
| Enumeration Date | 2025-09-08 |
| Last Update Date | 2025-09-08 |