| NPI | 1417109224 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3005725) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KY 1108147) |
| 163W00000X Registered Nurse (Licence: OH 311941) | |
| 363LF0000X Nurse Practitioner, Family (Licence: KY 3005725) | |
| Enumeration Date | 2008-10-13 |
| Last Update Date | 2021-05-14 |