| NPI | 1679164016 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3015169) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CT 15460) |
| 363LF0000X Nurse Practitioner, Family (Licence: TX 1203369) | |
| Enumeration Date | 2021-01-28 |
| Last Update Date | 2025-10-10 |