| NPI | 1174761464 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: KY 3005987) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 3005987) |
| 363LF0000X Nurse Practitioner, Family (Licence: KY 3005987) | |
| Enumeration Date | 2009-01-26 |
| Last Update Date | 2020-06-03 |