| NPI | 1023191392 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3004971) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OH RN09464) |
| 363LF0000X Nurse Practitioner, Family (Licence: KY 4971P) | |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2021-01-05 |