| NPI | 1194932376 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 5217P)  | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KY 1038670)  | 
| 163WL0100X Registered Nurse, Lactation Consultant (Licence: KY 193-11146)  | |
| Enumeration Date | 2007-05-17 | 
| Last Update Date | 2019-04-25 |