| NPI | 1417266958 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3006647) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 6647P) |
| Enumeration Date | 2010-10-01 |
| Last Update Date | 2019-02-25 |