| NPI | 1225020506 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 4188P) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OH 08056) |
| Enumeration Date | 2005-08-22 |
| Last Update Date | 2013-03-19 |