| NPI | 1205925930 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: KY 1058939) |
| Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: KY 1058939) |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2007-07-08 |