| NPI | 1174822357 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3006977) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 15709) |
| Enumeration Date | 2011-03-27 |
| Last Update Date | 2011-07-07 |