| NPI | 1184739591 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 4951P) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 4951P) |
| Enumeration Date | 2006-08-19 |
| Last Update Date | 2015-05-26 |