| NPI | 1093175754 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3010854) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN232674) |
| Enumeration Date | 2016-02-24 |
| Last Update Date | 2017-02-22 |