| NPI | 1902919103 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3002273) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: KY 3002273) |
| 363L00000X Nurse Practitioner (Licence: KY 3002273) | |
| Enumeration Date | 2006-08-15 |
| Last Update Date | 2025-11-10 |