| NPI | 1902596695 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 4001426) |
| Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: KY 4001426) |
| Enumeration Date | 2023-05-08 |
| Last Update Date | 2024-02-26 |