| NPI | 1265873046 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3008127) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SC 18615) |
| Enumeration Date | 2013-07-09 |
| Last Update Date | 2015-08-18 |