| NPI | 1689494866 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: KY 4029015) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 37537) |
| Enumeration Date | 2024-10-14 |
| Last Update Date | 2025-10-18 |