| NPI | 1083939425 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 2093P) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: KY 1048667) |
| Enumeration Date | 2010-03-29 |
| Last Update Date | 2010-03-29 |