| NPI | 1235565367 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3008378) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 54330) |
| Enumeration Date | 2013-09-20 |
| Last Update Date | 2018-09-10 |