| NPI | 1124485776 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: LA AP08683) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KY 130480) |
| Enumeration Date | 2016-01-26 |
| Last Update Date | 2016-05-18 |