| NPI | 1114904265 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3002419) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KY KY 1030153 24198) |
| Enumeration Date | 2005-12-29 |
| Last Update Date | 2015-07-10 |