| NPI | 1225300783 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3009205) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 5005107) |
| Enumeration Date | 2012-01-30 |
| Last Update Date | 2015-08-10 |