| NPI | 1093931487 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3005150) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 1081865) |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2015-06-04 |