| NPI | 1508330499 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: KY 3013113) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: KY F01190666) |
| Enumeration Date | 2019-01-14 |
| Last Update Date | 2025-08-27 |