| NPI | 1114279635 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3007639) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WV 63087) |
| Enumeration Date | 2012-10-08 |
| Last Update Date | 2012-10-08 |