| NPI | 1689431975 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 4002188) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IN 71014679A) |
| Enumeration Date | 2024-03-04 |
| Last Update Date | 2024-03-04 |