| NPI | 1356664262 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3006389) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 6389P) |
| Enumeration Date | 2010-03-05 |
| Last Update Date | 2019-10-29 |