| NPI | 1245215086 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3004671) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 4671P) |
| Enumeration Date | 2005-12-14 |
| Last Update Date | 2015-04-23 |