| NPI | 1629357959 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: KY 3006727) |
| Additional Taxonomies | 261QM2500X Clinic/Center, Medical Specialty (Licence: KY 3006727) |
| Enumeration Date | 2011-08-04 |
| Last Update Date | 2024-03-12 |