| NPI | 1114927704 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3003706) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KY 1097962) |
| Enumeration Date | 2005-07-26 |
| Last Update Date | 2015-09-22 |