| NPI | 1023105780 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3002597) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 3002597) |
| Enumeration Date | 2006-10-06 |
| Last Update Date | 2017-12-11 |