| NPI | 1912437526 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3015617)  | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024173816)  | 
| 363LF0000X Nurse Practitioner, Family (Licence: IN 71015859A)  | |
| Enumeration Date | 2017-06-15 | 
| Last Update Date | 2024-12-03 |