| NPI | 1144639519 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3008814) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OH COA.16361-NP) |
| Enumeration Date | 2014-08-10 |
| Last Update Date | 2018-10-03 |