| NPI | 1043596877 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: KY 3007136) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 3007136) |
| Enumeration Date | 2011-10-25 |
| Last Update Date | 2013-10-28 |