| NPI | 1104078369 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3005848) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 46753) |
| Enumeration Date | 2008-10-21 |
| Last Update Date | 2023-07-18 |