| NPI | 1114909819 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3004515) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 4515P) |
| Enumeration Date | 2005-11-17 |
| Last Update Date | 2016-07-15 |