| NPI | 1770369308 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 4017372) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IN 71015080A) |
| Enumeration Date | 2023-09-08 |
| Last Update Date | 2024-11-27 |