| NPI | 1003008095 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3005204) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 5204P) |
| Enumeration Date | 2007-08-14 |
| Last Update Date | 2019-08-02 |