| NPI | 1508414145 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3013780) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 3013780) |
| Enumeration Date | 2019-08-27 |
| Last Update Date | 2026-05-09 |