| NPI | 1104836410 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3237P) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: KY 3237P) |
| Enumeration Date | 2006-08-09 |
| Last Update Date | 2015-11-23 |