| NPI | 1265767867 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3006281) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 6281) |
| Enumeration Date | 2009-10-15 |
| Last Update Date | 2014-07-07 |