| NPI | 1811778129 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 4010937) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AL 1-177065) |
| Enumeration Date | 2023-10-12 |
| Last Update Date | 2024-07-25 |