| NPI | 1053613729 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 6714) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 3006714) |
| Enumeration Date | 2010-12-01 |
| Last Update Date | 2017-01-11 |