| NPI | 1205991817 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: KY 3005071) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: KY 5071P) |
| Enumeration Date | 2006-12-26 |
| Last Update Date | 2015-05-04 |