| NPI | 1629859582 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 4010189) |
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: KY 4010189) |
| Enumeration Date | 2023-10-06 |
| Last Update Date | 2023-12-07 |