| NPI | 1508759028 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LW0102X Nurse Practitioner, Women's Health (Licence: KY 3012957) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 3012957) |
| Enumeration Date | 2025-06-02 |
| Last Update Date | 2025-06-02 |