| NPI | 1790871218 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: KY 3004938) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KY 1091753) |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2024-01-11 |