| NPI | 1821883422 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 4042564) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KY 1164880) |
| Enumeration Date | 2025-04-14 |
| Last Update Date | 2025-07-09 |