| NPI | 1235203969 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3003321) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 3321P) |
| Enumeration Date | 2006-11-17 |
| Last Update Date | 2021-01-22 |