| NPI | 1699559658 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: KY 402235) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KY 1165690) |
| Enumeration Date | 2023-08-22 |
| Last Update Date | 2025-06-13 |