| NPI | 1700620184 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 4044830) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 4044830) |
| 363L00000X Nurse Practitioner (Licence: FL 11041349) | |
| 363LF0000X Nurse Practitioner, Family (Licence: IL 209029871) | |
| Enumeration Date | 2024-06-21 |
| Last Update Date | 2025-08-14 |