| NPI | 1801519657 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL 11022058) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 4031110) |
| Enumeration Date | 2022-09-26 |
| Last Update Date | 2024-11-27 |