| NPI | 1497432868 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 4005723)  | 
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KY 4005723)  | 
| Enumeration Date | 2023-06-28 | 
| Last Update Date | 2023-07-19 |