| NPI | 1417961053 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3003746) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 3746P) |
| 363LF0000X Nurse Practitioner, Family (Licence: KY 3003746) | |
| Enumeration Date | 2006-07-28 |
| Last Update Date | 2020-03-11 |