| NPI | 1790504371 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 4028830) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KY 4028830) |
| Enumeration Date | 2024-10-09 |
| Last Update Date | 2024-12-05 |