| NPI | 1073606539 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3003727) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 3727P) |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2017-01-24 |