| NPI | 1104080761 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL ARNP9216912) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 3008318) |
| Enumeration Date | 2008-07-14 |
| Last Update Date | 2015-08-18 |