| NPI | 1205909330 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3003830) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 3830P) |
| 363LF0000X Nurse Practitioner, Family (Licence: KY 3830P) | |
| Enumeration Date | 2006-11-16 |
| Last Update Date | 2011-09-16 |