| NPI | 1013111939 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3005412) |
| Additional Taxonomies | 163WG0000X Registered Nurse General Practice (Licence: KY 1096981) |
| 363L00000X Nurse Practitioner (Licence: KY 5412P) | |
| 363LF0000X Nurse Practitioner Family (Licence: KY 3005412) | |
| Enumeration Date | 2007-06-13 |
| Last Update Date | 2021-01-22 |