| NPI | 1154460467 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3004861) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 4861P) |
| Enumeration Date | 2007-02-05 |
| Last Update Date | 2023-08-25 |