| NPI | 1235115536 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3003750) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OH COA 10689-NP) |
| Enumeration Date | 2005-12-19 |
| Last Update Date | 2013-12-20 |