| NPI | 1639744097 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3015796) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 3015796) |
| 363LF0000X Nurse Practitioner, Family (Licence: MS 907292) | |
| 363LF0000X Nurse Practitioner, Family (Licence: CT 15318) | |
| Enumeration Date | 2021-05-26 |
| Last Update Date | 2025-09-09 |