| NPI | 1164675278 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3005792) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 5792P) |
| Enumeration Date | 2008-11-03 |
| Last Update Date | 2017-01-10 |