| NPI | 1720699010 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3014664) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 3014664) |
| Enumeration Date | 2020-08-11 |
| Last Update Date | 2026-03-10 |