| NPI | 1164613568 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3005046) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 5046P) |
| Enumeration Date | 2007-08-09 |
| Last Update Date | 2020-10-23 |