| NPI | 1639934706 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 4015826) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IN 71015915A) |
| 363LF0000X Nurse Practitioner, Family (Licence: KY 4015826) | |
| Enumeration Date | 2024-02-19 |
| Last Update Date | 2026-02-27 |