| NPI | 1205890142 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3004619) |
| Additional Taxonomies | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: KY 4619P) |
| 363L00000X Nurse Practitioner (Licence: KY 4619p) | |
| Enumeration Date | 2006-04-17 |
| Last Update Date | 2020-12-04 |