| NPI | 1124101332 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3003560) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 3560P) |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2015-04-11 |