| NPI | 1184056475 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: KY 3008227) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KY 1120533) |
| Enumeration Date | 2013-08-08 |
| Last Update Date | 2013-08-08 |