| NPI | 1336104686 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3002225) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KY 1082370) |
| 363LF0000X Nurse Practitioner, Family (Licence: KY 2225P) | |
| Enumeration Date | 2006-04-19 |
| Last Update Date | 2021-09-13 |