| NPI | 1073510392 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: KY 1033529) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: KY 1778P) |
| 364SA2200X Clinical Nurse Specialist Adult Health (Licence: KY 1778S) | |
| Enumeration Date | 2005-07-01 |
| Last Update Date | 2008-05-12 |